Jaw Dysfunction

Temporo-mandibular Joint Dysfunction (TMD)

Do you know that headache, neck pain, shoulder pain, arm numbness, back pain could be related to your jaw dysfunction?

We approach TMD patients by examining and diagnosing the cause of pain and applying appropriate management to relieve symptoms. This treatment may include (but not be limited to), physical therapy, myofascial trigger points, TMJ mobilisation, postural correction combined with specific jaw exercises. This approach is often successful in alleviating the problem quickly and inexpensively.

Some patients however, may have significant jaw damage and may require the services of an appropriately experienced and qualified Dentist specialising in jaw. Dental treatment can often require the prescription of a removable appliance worn temporarily inside the mouth to change jaw joint position and the way the teeth come together.

If this is successful, then possibly no more treatment is required but in some cases the dental bite needs to be permanently changed to gain lasting relief from jaw symptoms. In this case orthodontic type treatment can be the answer.

There are two types of TMD:

Extra-Capsular (outside the joint) Dysfunction

Extra-capsular problems are caused by biting interferences due to misaligned teeth, poor restorations (fillings, crowns or dentures), or due to clenching or grinding of the teeth. This leads to excessive contraction of the closing muscles, which results in headaches and jaw aches. Treatment is aimed at removing the biting interferences and reducing the closing muscles from excessive contractions.

Intra-Capsular (within the joint) Dysfunction

Intra-capsular problems are caused by the dislocation on the disc within the joint between the head (temporal bones) and the lower jaw (mandible). The disc is no longer sitting within the joint but at the front of the joint, which results in the clicking of the jaw, potential crepitus (bone rubbing on bone), with restricted mouth opening and limited range of motion. Left untreated, the lower jaw is pushed back and upwards, compressing the nerve and blood vessels which puts a strain on the muscles and other joints. It can lead to headaches, pain in the neck and shoulder, facial asymmetry, numbness in arms and hands, postural issues and uneven shoulders.

TMD, Posture & Pain

Postural change can result from a descending problem (head downwards) or an ascending problem (foot upwards).

When the upper jaw is not leveled or the lower jaw is backwards relative to
the upper jaw. The following changes with associated symptoms and signs
as below:

Head, Neck, Shoulder, Hip, Leg Pain

Scoliosis, Poor Posture

Postural Distortions & Scoliosis

Headache, Shoulder, Back, Hip, Knee, Foot Pain

TMD & Teeth Grinding

Teeth grinding is the involuntary clenching, grinding and gnashing of the teeth. This generally occurs while the person is asleep, but is also known to happen whilst awake. Grinding of teeth can be a physical expression of stress.

Symptoms include:

Left untreated, grinding can lead to broken teeth and cause TMD.

TMD & Snoring

Snoring is defined as a partial blockage of the airway, and can have serious health risks as well as social implications between partners. When snoring lasts 10 seconds or more, this can lead to Obstructive Sleep Hypopnea. In more serious cases, there may be a complete blockage of the airway (Obstructive Sleep Apnea). Both of these conditions may lead to a decrease in oxygen and an increase in carbon dioxide in the blood, causing the heart rate and breathing rate to increase. It may also cause frequent wake-ups, affecting the quality of sleep.

The consequences of this condition may cause:

TMD Treatment

by Functional Dentist

Extra-Capsular (outside the joint) Dysfunction

Treatment is aimed at decompression of the nerve and blood vessels and to restore the joint to a more physiological position. The aim is to bring the lower jaw downwards and forwards to eliminate the clicking by recapturing the dislocated disc. This will greatly reduce the symptoms of TMD. When the head is shifted off the centre of the top of the neck, the rest of the body will compensate for the shift of weight. The spine and pelvis will twist, causing one shoulder to drop down, one hip to be pulled up, bringing the leg with it to create body imbalance. The stress and tension on the muscles can cause pain anywhere in the body.

Temporo-mandibular Joint Dysfunction (TMD)

Extra-Capsular (outside the joint) Dysfunction

Intra-Capsular (within the joint) Dysfunction